Date of Award

Spring 2026

Document Type

Open Access Thesis

Department

Public Health

First Advisor

Mufaro Kanyangarara

Abstract

The COVID-19 pandemic has disproportionately affected African American communities, revealing longstanding disparities in healthcare access and outcomes. In South Carolina, where these inequities are particularly evident, understanding the determinants of COVID-19 vaccine uptake among African Americans is crucial for advancing health equity. This thesis examines vaccination coverage and explores social, economic, and psychological predictors of vaccine uptake in a sample of 305 African American adults through a cross-sectional survey conducted in 2023.

Vaccination status was categorized as unvaccinated, partially vaccinated, and fully vaccinated (with or without a booster). Ordinal logistic regression analyses were performed to examine associations between vaccination status and demographic, socioeconomic, and psychological variables, including age, gender, education, employment, health insurance, and social proximity of COVID-19.

In the final multivariate model, social proximity of COVID-19 emerged as the strongest and most significant predictor of vaccination status (OR = 1.80, 95% CI: 1.40–2.31, p < 0.001). Participants who knew more individuals affected by COVID-19 were significantly more likely to be vaccinated. Age was also a significant factor, with respondents aged 46–60 (OR = 2.01, 95% CI: 1.01–4.00, p = 0.046) and those aged 61 and older (OR = 6.118, 95% CI: 2.02–18.54, p = 0.001) having higher odds of vaccination compared to participants aged 18–30. Gender (p = 0.34) and health insurance coverage (p = 0.21) were not statistically significant in the multivariate model.

Rights

© 2026, Brittany Divon Smith

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